douglas b. marlowe, j.d., ph.d
DESCRIPTION
Evidence-Based Dispositions for Drug Offenders. Treatment Research Institute at the University of Pennsylvania. Douglas B. Marlowe, J.D., Ph.D. Dispositions for Drug Offenders. Psychosocial Functioning. $$$$$$ Costs $$$$$$$$$. Public Safety Risks. Drug Courts. Incarceration. - PowerPoint PPT PresentationTRANSCRIPT
Douglas B. Marlowe, J.D., Ph.D.
Treatment Research Institute at the
University of Pennsylvania
Evidence-Based Dispositions for Drug
Offenders
Dispositions for Drug Offenders
Pre-plea diversion
(ARD)
IncarcerationDrug Courts
Intermediatesanctions
Psychosocial Functioning
$$$$$$ Costs $$$$$$$$$
Public Safety Risks
Disposition beforejudgment (Prop. 36)
Prognostic Risks• Current age < 25 years
• Delinquent onset < 16 years
• Substance abuse onset < 14 years
• Prior rehabilitation failures
• History of violence
• Antisocial Personality Disorder
• Psychopathy
• Familial history of crime or addiction
• Criminal or substance abuse associations
Criminogenic Needs
Substance Dependence or Addiction
Criminogenic Needs
Substance Dependence or Addiction1. Binge pattern2. Cravings or compulsions3. Withdrawal symptoms
Criminogenic Needs
Substance Dependence or Addiction1. Binge pattern2. Cravings or compulsions3. Withdrawal symptoms
} Abstinence is a distal goal
Criminogenic Needs
Substance Dependence or Addiction1. Binge pattern2. Cravings or compulsions3. Withdrawal symptoms
Substance Abuse
} Abstinence is a distal goal
Criminogenic Needs
Substance Dependence or Addiction1. Binge pattern2. Cravings or compulsions3. Withdrawal symptoms
Substance Abuse
} Abstinence is a distal goal
Abstinence is a proximal goal}
Criminogenic Needs
Substance Dependence or Addiction1. Binge pattern2. Cravings or compulsions3. Withdrawal symptoms
Substance Abuse
Collateral needs– Dual diagnosis– Chronic medical condition (e.g., HIV+, HCV, diabetes)– Homelessness, chronic unemployment
} Abstinence is a distal goal
Abstinence is a proximal goal}
Criminogenic Needs
Substance Dependence or Addiction1. Binge pattern2. Cravings or compulsions3. Withdrawal symptoms
Substance Abuse
Collateral needs– Dual diagnosis– Chronic medical condition (e.g., HIV+, HCV, diabetes)– Homelessness, chronic unemployment
} Abstinence is a distal goal
Abstinence is a proximal goal}
} Regimen compliance is proximal
High Risk Low Risk
High Needs
Low Needs
Risk & Needs Matrix
Risk & Needs Matrix
High Risk Low Risk
High Needs
Low Needs
Accountability,Treatment &Habilitation
Risk & Needs Matrix
High Risk Low Risk
High Needs
Low Needs
Treatment&
Habilitation
Accountability,Treatment &Habilitation
Risk & Needs Matrix
High Risk Low Risk
High Needs
Low Needs
Accountability&
Habilitation
Treatment&
Habilitation
Accountability,Treatment &Habilitation
Risk & Needs Matrix
High Risk Low Risk
High Needs
Low Needs
Prevention Accountability
&Habilitation
Treatment&
Habilitation
Accountability,Treatment &Habilitation
Practice Implications
High Risk Low Risk
High Needs
Low Needs
Status hearings Treatment & habilitation Compliance is proximal Restrictive consequences Positive reinforcement Agonist medication
Noncompliance hearings Treatment & habilitation Treatment is proximal
Positive reinforcement Agonist medication
v.o.p. / status calendar Abstinence is proximal Psychosocial habilitation Restrictive consequences No AA or MET Antagonist medication
Secondary prevention Abstinence is proximal No AA or MET Individual counseling or stratified groups
Dispositions for Drug Offenders
IncarcerationDrug Courts
Intermediatesanctions
Low riskLow needs
Low riskHigh needs
High riskHigh needs High risk
Low needs
Risk ofDangerousness
Pre-plea diversion
(ARD)Disposition before
judgment (Prop. 36)